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A randomized intervention trial to reduce the lending of used injection equipment among injection drug users infected with hepatitis C.

Latka MH, Hagan H, Kapadia F, Golub ET, Bonner S, Campbell JV, Coady MH, Garfein RS, Pu M, Thomas DL, Thiel TK, Strathdee SA

Division of International Health and Cross Cultural Medicine, University of California School of Medicine, 9500 Gilman Dr, Mailstop 0622, La Jolla, CA 92093, USA.

OBJECTIVES: We evaluated the efficacy of a peer-mentoring behavioral intervention designed to reduce risky distributive injection practices (e.g., syringe lending, unsafe drug preparation) among injection drug users with hepatitis C virus (HCV) infection. METHODS: A randomized trial with a time-equivalent attention-control group was conducted among 418 HCV-positive injection drug users aged 18 to 35 years in 3 US cities. Participants reported their injection-related behaviors at baseline and at 3- and 6-month follow-ups. RESULTS: Compared with the control group, intervention-group participants were less likely to report distributive risk behaviors at 3 months (odds ratio [OR]=0.46; 95% confidence interval [CI]=0.27, 0.79) and 6 months (OR=0.51; 95% CI=0.31, 0.83), a 26% relative risk reduction, but were no more likely to cite their HCV-positive status as a reason for refraining from syringe lending. Effects were strongest among intervention-group participants who had known their HCV-positive status for at least 6 months. Peer mentoring and self-efficacy were significantly increased among intervention-group participants, and intervention effects were mediated through improved self-efficacy. CONCLUSIONS: This behavioral intervention reduced unsafe injection practices that may propagate HCV among injection drug users.

Published 25 April 2008 in Am J Public Health, 98(5): 853-61.
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